Borongosam, Binasing M.

HRN: 16-92-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/16/2024
ACICLOVIR 800MG (TAB)
10/16/2024
10/23/2024
ORAL
800mg
5x A Day
Herpes Zoster
Waiting Final Action 
10/16/2024
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/16/2024
10/16/2024
IV
4.5G
ONCE
CAP MR
Rejected 
10/16/2024
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
10/17/2024
10/23/2024
IV
2.25G
TID
CAPMR, SKIN INFECTION
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: